Lifestyle

Is It a Cold or the Flu? How to Tell the Difference, and Why It Matters More After 65

By Mike Harper · October 28, 2026

A scratchy throat and a stuffy nose can be the start of a cold or the start of the flu. The two illnesses share several symptoms, but they are caused by different viruses, and for adults 65 and older, telling them apart early can make a real difference.

The National Institute on Aging says a cold is often milder than the flu. A health care provider can confirm which one you have, but a few clues tend to point one way or the other.

How fast it starts. The Centers for Disease Control and Prevention says flu symptoms usually come on suddenly. In the agency’s comparison chart, a cold comes on gradually, while the flu is abrupt.

Fever and chills. Fever is rare with a cold, according to the CDC, but common with the flu, where it lasts three to four days. Chills are uncommon with a cold and fairly common with the flu. The CDC adds that not everyone with the flu will have a fever.

Aches and exhaustion. Body aches are common with the flu and often severe, the CDC says. The NIA says people with the flu can have general aches and pains and a headache, and they feel very tired. The CDC lists headache as rare with a cold.

Nose and throat. Sneezing, a stuffy nose and a sore throat can come with either illness, but the NIA says they are less common with the flu.

Cough and chest discomfort. With a cold, the CDC describes these as mild to moderate, with a hacking cough. With the flu, they are common and can be severe.

Fever can also look different in older adults. The NIA notes that normal body temperatures in older adults are slightly lower than in younger adults, so a fever may be lower too. Citing the CDC, it says a single reading above 100°F, repeated readings above 99°F, or a rise of more than 2°F above a person’s normal temperature may be signs of an infection.

Why age matters. The CDC says people 65 and older are at higher risk of developing serious flu complications compared with young, healthy adults, due in part to changes in immune defenses with age. The agency estimates that in recent years, between 70 percent and 85 percent of seasonal flu deaths and between 50 percent and 70 percent of flu hospitalizations have been in this age group. The NIA adds that older adults are more likely to have other conditions, like diabetes, that raise the risk.

Pneumonia is a serious complication, and the CDC says the flu can also make chronic problems such as heart disease worse.

Why timing matters. The CDC says people 65 and older should call their health care provider right away if they get flu symptoms. Prescription antiviral drugs work best when started early, ideally within two days after symptoms begin, the agency says. They can make the illness milder, shorten it by about a day and may help prevent some complications. Antibiotics do not work against flu viruses.

Get care right away for these warning signs in adults, according to the CDC: difficulty breathing or shortness of breath, persistent pain or pressure in the chest or abdomen, persistent dizziness or confusion, seizures, not urinating, severe muscle pain, severe weakness or unsteadiness, a fever or cough that improves and then returns or worsens, or a chronic condition that gets worse.

The CDC calls an annual flu vaccine the best protection, and it preferentially recommends higher dose or adjuvanted vaccines for people 65 and older.

This article is for general information and is not medical advice. Talk with your doctor about any symptoms, and seek emergency care for trouble breathing or chest pain. This article was produced with the assistance of AI and fact-checked against the sources cited by LightWave Reports.